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CPT 64596

INS/RPLCMT PRQ ELTRD RA PN 1

Reported by 343 hospitals in the network under the case rate methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

National pricing summary

Low

$10

Average

$11.5k

Median

$11.1k

High

$44.5k

Hospitals reporting this code

#HospitalLocationApproximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price.
1The Finley HospitalDubuque, IA$12.5k$12.6k$548—$12.2k$28.8k
2Northwest Iowa Hospital CorporationSioux City, IA$12.6k$12.6k$182—$12.4k$33.3k
3Medical Ctiy ArgyleArgyle, TX$16.2k$13.1k$9.6k—$948$40.6k
4Medical City AllianceSAGINAW, TX$17.9k$15.5k$8.2k—$2.1k$36.6k
5St Luke's Methodist HospitalCedar Rapids, IA$12.0k$12.0k$173—$11.8k$31.0k
6Trinity Medical CenterRock Island, IL$13.3k$14.0k$2.2k—$12.2k$35.4k
7Trinity Medical CenterBettendorf, IA$12.1k$12.8k$2.3k—$11.7k$32.0k
8Unity HealthcareMuscatine, IA$11.9k$12.7k$2.2k—$11.5k$37.5k
9Trinity Regional Medical CenterFort Dodge, IA$11.9k$11.9k$172—$11.7k$32.7k
10Meriter Hospital, IncMadison, WI$12.0k$11.6k$1.1k—$8.7k$28.4k
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Look up this code directly

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